Another fine CME article from JAAPA.
Microalbuminuria tends to occur long before clinical proteinuria becomes evident.
Proteinuria results when the glomerular basement membrane allows excess proteins into the tubular filtrate and when the proximal tubules are unable to reabsorb low-molecular-weight proteins.
False-negative dipstick results may occur if the urine is dilute or if protein loss is mild.
Correlation between the urine protein-creatinine ratio (UPCR) and the 24-hour urine collection has been demonstrated in several diseases, and recent evidence indicates that the UPCR ratio is more accurate than the 24-hour measurement.
The albumin-to-creatinine ratio is more sensitive than the UPCR.
Renal biopsy should be considered in adults with persistent proteinuria because results are likely to guide specific therapy.